States Characterisation Procedure (SCP) for supporting the reformulation of patients with borderline/dissociative features

For supporting the reformulation of patients with borderline/ dissociative features (October, 2007) This is essentially a shorter, 2-page version of the States Description Procedure (SDP), easier to complete and analyse and modified in some details.

Uses

If dissociated states have been identified in the assessment process or if patients have completed the Personality Structure Questionnaire and have scored 28+, or have checked many of the states on the back page of the Psychotherapy File, the idea of states will have already been introduced. Following this with the use of the SCP can yield a systematic account of the patient’s structural dissociation by identifying the range of states and demonstrating the role with which the state is associated and its reciprocal.

Aim

The aim is to describe clearly the experiences associated with each state and to demonstrate the roles played and the perceived reciprocations when in the state. This steers patient and clinician from a descriptive towards a dialogic/RRP understanding.

Procedure

Explain the forms to the patient, emphasising that page 2 needs to be completed for each state. Some patients may need help with completion, at least to start with.

Analysis

List names of identified states from page 1.

Then note from page 2, paras 1 and 2 the features described in relation to each state.

For each state summarise (from para 3, A and B) the role played and the perceived reciprocal in this state and from C the self to self roles. The features listed on page 2 can be supplemented by enquiry, diary keeping etc.

Consider whether the states associated with both poles of key RRPs can be identified. Consider whether some states may be amalgamated. You should then have identified all the more or less dissociated states and this will contribute to the construction of a Self States Sequential Diagram.

(Analysis of a series of patients completing the SDP combining the features and RRPs for each state showed three main categories: Subjectively positive, almost no harsh RRPs and only occasional dissociative symptoms Subjectively negative states with harsh RRPs and with dissociative or somatising features Subjectively negative states with harsh RRPs with no dissociative or somatising features (Ryle (2007) Clinical Psychology and Psychotherapy, 14, 5, 329-341)